广西小学儿童二手烟暴露及相关致癌物质摄入情况分析  

Analysis of exposure to secondhand smoke and intake of carcinogens in primary school children in Guangxi

作　　者：孟军[1] 毛玮[1] 唐阳 黄金梅[1] 刘多 滕有明[1] 蔡剑锋[1] 许晶晶[1] MENG Jun;MAO Wei;TANG Yang;HUANG Jin-mei;LIU Duo;TENG You-ming;CAI Jian-feng;XU Jing-jing(Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control,Nanning,Guangxi 530028,China)

机构地区：[1]广西壮族自治区疾病预防控制中心

出　　处：《应用预防医学》2019年第4期283-287,共5页Applied Preventive Medicine

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z20180981)

摘　　要：目的了解广西小学儿童二手烟暴露及相关致癌物质摄入情况,为进一步采取控烟措施提供参考。方法在广西南宁市选择3所小学开展调查。根据家长自述的儿童可能二手烟暴露情况分成A、B、C、D组,每组50户。对各调查户中的在校儿童进行问卷调查和尿液检测,分析体内可替宁、4-(甲基亚硝胺)-1-(3-吡啶)-1-丁醇(NNAL)总量摄入情况及其影响因素。结果共调查205名儿童,尿液可替宁和NNAL总量浓度的中位数分别为1.50 ng/mL和0.005 pmol/mL,检出率分别为96.10%和62.93%。4组儿童中NNAL总量检出率差异有统计意义(X^2=8.68,P<0.05),最高为B组(父亲或母亲吸烟但从不在家里吸烟,其他家庭成员也从不在家里吸烟),检出率为76.92%,最低为C组(父母亲及其他家庭成员均不吸烟,但儿童经常暴露在户外二手烟环境中),检出率为53.06%。4组儿童中可替宁和NNAL总量检出浓度平均值差异均有统计学意义(P<0.05),可替宁检出浓度中位数B组最高,为2.20 ng/mL,NNAL总量检出浓度A组(父亲或母亲吸烟且经常在家里吸烟)最高,其浓度中位数为0.011 pmol/mL。农村儿童可替宁检出率高于城市儿童(X^2=9.27,P<0.01),检出率为100.00%;农村儿童可替宁检出浓度略高于城市(P<0.05),中位数为1.80 ng/mL。不同房屋性质的儿童NNAL总量检出率差异有统计学意义(X^2=12.91,P<0.01),其他类型住房的儿童检出率最高(100.00%);不同房屋性质的儿童中可替宁和NNAL总量检出浓度平均值差异均有统计学意义(P均<0.05)。调查儿童尿液可替宁、NNAL总量水平之间存在正相关(r=0.898,P<0.001)。多重响应变量分析结果显示,各选项响应值位于0.98%~78.54%之间,在地点选项中可替宁和NNAL总量检出情况最多的选项均为学校。结论受调查的儿童大部分已暴露于二手烟环境中,应尽快出台公共场所禁烟措施,加快立法进程,加强民众的健康教育,提倡健康的生活方式,有效减少二手Objective To investigate the exposure and carcinogen intake of secondhand smoke in primary school children in Guangxi,providing the reference for the further measures to control smoking.Methods Three primary schools in Nanning city of Guangxi were investigated.According to the parents’self-reported on the possibility of children exposure to secondhand smoke,the children were asinged into group A,B,C and D,and each group had children from 50 households.Questionnaire and urine test for the school children in each survey household were conducted,and the content intake of cotinine and the total of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol(NNAL)in body and its influencing factors were analyzed.Results In total,205 children were investigated.The median of the concentrations of cotinine and NNAL in urine were 1.50 ng/ml and 0.005 pmol/ml;the detection rate were 96.10%and 62.93%,respectively.The difference in the total detection rate of NNAL among the four groups of children was statistically significant(X^2=8.68,P<0.05);the highest was group B(father or mother smoked but never smoked at home,other family members never smoked at home),the detection rate was 76.92%,and the lowest was group C(parents and other family members do not smoke,but children are often exposed to outdoor second-hand smoke),the detection rate was 53.06%.There were significant differences in the mean concentrations of cotinine and NNAL in the four groups(P<0.05),and the highest concentration in the B group was 2.20(1.25,3.23)ng/ml.The concentration of NNAL in group A(father or mother smoking and often smoking at home)was the highest,with a median of 0.011 pmol/ml.The cotinine detection rate among children in rural areas was higher than urban children(X^2=9.27,P<0.01),which was 100.00%.The concentration of cotinine found in rural children was slightly higher than urban children(P<0.05),and the median was 1.80 ng/ml.The difference in the detection rate of NNAL in children with different housing properties was statistically significant(X^2=12.91,P

关 键 词：二手烟 可替宁 4-(甲基亚硝胺)-1-(3-吡啶)-1-丁醇(NNAL) 检出率 影响因素 

分 类 号：R193[医药卫生—卫生事业管理]